Low profile retention system

ABSTRACT

Medical devices for retaining an end of a medical tube. Each of the devices of the present invention comprises a base and at least one tab having a portion that is moveable within the base. The base comprises an upper surface, a lower surface, at least one side cavity for receiving a tab, and an opening transverse to the upper and lower surfaces. To facilitate tube retention, the tube is inserted through the opening in the base and the tab(s) is(are) moved within the cavity(ies) such that a portion of each tab contacts and retains the tube.

RELATED APPLICATIONS

[0001] This is a continuation-in-part of U.S. Ser. No. 09/109,101, filedJul. 2, 1998.

FIELD OF THE INVENTION

[0002] The present invention relates to medical devices for theretention of flexible tubes such as gastrostomy feeding tubes.

BACKGROUND OF THE INVENTION

[0003] Various medical procedures result in the placement of flexibletubes within the body. While the distal end of such tubes remainsimplanted within the body, the proximal end extends outside of the bodyand must be retained.

[0004] For example, a gastrostomy (i.e., percutaneous endoscopicgastrostomy, surgically placed gastrostomy tube, or laparoscopicallyplaced gastrostomy tube) is performed in order to place a gastrostomy or“feeding” tube into a patient's stomach. The patient is fed directlythrough the feeding tube via the proximal end of the tube, which extendsfrom the patient's body through a stoma site. This procedure is used forlong-term feeding and to retain digestive functions of patientssuffering from neurological disease, brain injury, or tumors and/orinjuries of the head, neck, or esophagus, who thus have swallowingdifficulties but otherwise have functioning gastrointestinal tracts.

[0005] Another type of medical tube placed within the body are drainagecatheters, which are used in interventional radiology to drain fluidsfrom an organ or body cavity. The proximal end of the catheter extendsout of the body and typically has a plastic hub, which is attached andsecured to the patient.

[0006] The proximal ends of tubes such as gastrostomy tubes and drainagecatheters must be retained in a fixed position outside of the body toavoid movement into or out of the body and to provide support forfeeding procedures and external manipulation. Furthermore, the ends mustbe closed to prevent the leakage of body fluids from these tubes.Conventional retention systems use multiple components and arecumbersome to use due to inefficient ergonomics. Moreover, conventionalretention systems often do not provide sufficient retention strength.

SUMMARY OF THE INVENTION

[0007] The present invention includes medical devices for retaining anend of a medical tube. Each of the devices of the present inventioncomprises a base and at least one tab having a portion that is moveablewithin the base. The base comprises an upper surface, a lower surface,at least one side cavity for receiving a tab, and an opening in at leastone of the upper and lower surfaces. To facilitate tube retention, thetube is inserted through the opening in the base and the tab(s) is(are)moved within the cavity(ies) such that a portion of each tab contactsand retains the tube.

[0008] In one embodiment, the present invention includes a medicaldevice comprising a base and a first tab having a portion that ismoveable within the base. The base includes a first locking base featurefor engaging the first tab. The upper and lower surfaces of the basedefine a first side cavity between the upper and lower surfaces. Thefirst tab has a portion that is movable within the first side cavity, afirst locking tab feature that is engagable with the first locking-basefeature, and a first tube compression member extending from the distalend of the first tab. To facilitate tube retention, the tube is insertedthrough the opening in the base, the first tab is moved within the firstside cavity, and the first locking tab feature is engaged with the firstlocking base feature such that the tab is locked into the base and thefirst tube compression member contacts the tube.

[0009] In another embodiment of the present invention, the base includesa second side cavity between the upper and lower surfaces, and a secondlocking base feature. In this embodiment, the medical device includes asecond tab having a portion that is movable within the second sidecavity. The second tab includes a second locking tab feature that isengagable with the second locking base feature, and further includes asecond tube compression member extending from the distal end of thesecond tab. To facilitate tube retention, the tube is inserted throughthe opening in the base, the first and second tabs are moved within thefirst and second side cavities, respectively, and the first and secondlocking tab features are engaged with the first and second locking basefeatures, respectively, such that the tabs are locked into the base andthe first and second tube compression members contact the tube.

BRIEF DESCRIPTION OF THE DRAWINGS

[0010]FIG. 1 shows an exploded view of the components of an embodimentof the present invention in which two tabs are used.

[0011]FIG. 2 shows a cross-sectional view of an embodiment of thepresent invention when in use.

[0012]FIG. 3 shows a cross-sectional view of an embodiment of thepresent invention when in use with an external feeding tube insertedtherethrough.

[0013]FIG. 4 shows an assembled embodiment of the present invention.

[0014]FIG. 5 shows an embodiment of the present invention that includesa boot having an attached plug.

[0015]FIG. 6 shows a patterned boot, for use with an embodiment of thepresent invention.

[0016]FIG. 7 shows a top view of an embodiment of the present inventionin which two tabs are used.

[0017]FIG. 8 shows a stem with a mechanical surface thereon, inaccordance with an embodiment of the present invention.

[0018]FIG. 9 shows a perspective view of an embodiment of the presentinvention in which the base and tab portions are substantially mirrorimages of each other.

[0019]FIGS. 10A and 10B show top and bottom views, respectively, of thebase of an embodiment of the present invention.

[0020]FIG. 11 shows a perspective view of the base of an embodiment ofthe present invention in which one tab is used.

[0021]FIG. 12 shows a cross-sectional view of a single-tab embodiment ofthe present invention, when in use.

[0022]FIG. 13 shows a side view of an embodiment of the presentinvention in which a stem is attached to the base.

[0023]FIG. 14 shows a perspective view of an embodiment of the presentinvention in which a stem is attached to the base.

[0024]FIG. 15 shows a perspective view of a tab embodiment of thepresent invention.

DETAILED DESCRIPTION

[0025] The present invention relates to the retention of flexibleplastic tubes at desired locations and orientations in medicalapplications. The medical devices of the present invention are suitablefor use in any application in which a flexible tube extends from thebody and must be retained. Such applications include, for example,gastrostomy tubes, jejunostomy tubes, and drainage catheters (e.g.,nephrostomy, abscess, urinary, and biliary drainage, and othermultipurpose drainage applications). The medical devices of the presentinvention retain and support the ends of these tubes when protrudingfrom the body. The medical devices of the present invention are lowprofile and thus easily fit beneath a patient's clothing. Furthermore,the medical devices of the present invention are easy to use and providehigh retention strength. A further advantage of the medical devices ofthe present invention is that they provide a novel and reliable valveand feeding system interface.

[0026] One embodiment of the present invention, including its variouscomponents, is shown in FIG. 1. The medical device 200 includes a base210, a first tab 230, a second tab 240 and a stem 250.

[0027] The base 210 includes upper and lower surfaces 211, 212, andproximal and distal ends 213, 214. The upper and lower surfaces 211, 212define an opening 215 for receiving a tube to be retained. The upper andlower surfaces 211, 212 further define a first side cavity 216 and asecond side cavity 217. The first side cavity 216 extends from theopening 215 to the proximal end 213. The second side cavity 217 extendsfrom the opening 215 to the distal end 214. In this embodiment, the base210 includes a plurality of first locking base features 218 in the uppersurface 211 between the opening 215 and the proximal end 213. The base210 further includes a plurality of second locking members 219 in theupper surface 211 between the opening 215 and the distal end 214.

[0028] The medical device 200 includes first and second tabs 230, 240,which are substantially identical in structure. The first and secondtabs 230, 240 are movable within first and second cavities 216, 217,respectively. The first and second tabs 230, 240 comprise respectiveupper 231, 241 and lower 232, 242 surfaces. The upper surfaces 231, 241each have at least one locking tab feature 235, 245 that is (are)engagable with respective locking base features 218, 219. The first andsecond tabs 230, 240 further comprise tube compression members 236, 246and window locking members (shown as 248 for the second tab 240)extending from distal ends 234, 244, respectively. The first and secondtabs 230, 240 each optionally include respective tube closing members(shown as 247 for the second tab 240). The base 210 and tabs 230, 240are made from any suitable material that provides sufficient strengthfor the intended application yet allows the locking base features 218,219 and/or locking tab features 235, 245 to flex for engagement witheach other. Preferred materials for the base 210 and tabs 230, 240include polypropylene, acrylonitrile butadiene styrene, polycarbonate,polyethylene, and mixtures and copolymers thereof.

[0029] The stem 250 includes a tubular bottom portion 251 whichcomprises a cylindrical side wall, a top end 252 and a bottom end 253;and a positioning member 254 at the top end 252 of the tubular bottomportion 251. The positioning member 254 includes an opening that iscoaxial with the tubular bottom portion 251. Optionally, at least oneretention window 255 is located within the cylindrical side wall of thebottom portion 251. The stem 250 is made from any suitable material suchas, for example, metallic materials such as stainless steel, copper,nitinol, or brass; and polymeric materials such as polypropylene,acrylonitrile butadiene styrene, polycarbonate, polyethylene, andmixtures and copolymers thereof. It is generally preferred, however,that the stem 250 comprise a metallic material.

[0030] The operation of the medical device 200 is now described withreference to FIGS. 1 to 3. A distal end of a tube 500 to be retained(e.g., a gastrostomy feeding tube) is positioned to a desired locationwithin the body (e.g., the stomach) such that the proximal end extendsfrom the exterior of the body (e.g., through a stoma site). A hemostatis then clipped to the tube, which is thereafter cut to a suitablelength to thereby leave a short stub in which the stem 250 is inserted.The stem 250 is inserted into the proximal end 501 of the tube 500 suchthat the bottom portion 251 is substantially surrounded by the innercircumference of the tube 500. The outer diameter of the bottom portion251 is preferably about the same or greater size than the inner diameterof the tube 500, thus ensuring a tight fit between the two. Thepositioning member 254 remains outside of the tube and is preferablyplaced against the proximal end of the tube when in use.

[0031] The opening 215 in the base 210 is configured to receive the tube500 with the stem 250 therein. As shown in FIG. 1, the opening 215 inthe lower surface 212 of the base 210 preferably has a shape thatreflects the shape of the positioning member 254. The base 210 is placedover the tube such that the stem 250 passes through the opening 215 andextends beyond the upper surface 211 of the base 210. The base 210 isthen rotated so that, when released, the positioning member 254 willrest against the upper surface 211 of the base 210. In the embodimentshown in FIG. 1, the base 210 is rotated 90° such that the positioningmember 254 rests in alignment recesses 220 in the upper surface 211 ofthe base 210. The alignment recesses 220 serve the addition function ofaligning retention windows 255, if present, with the window lockingmembers 238, 248 on the first and second tabs 230, 240, respectively.

[0032] After the tube is inserted through the base 210 and thepositioning member 254 of the stem 250 is resting against the uppersurface 211 of the base 210, the first and second tabs 230, 240 aremoved within first and second cavities 216, 217, respectively, towardsthe opening 215 in the base 210 such that the locking tab features 235,245 engage with the locking base features 218, 219, respectively. Whenfully inserted, the first and second tabs 230, 240 hold the tube 500 bycompression with the tube compression members 236, 246 and, preferably,with the window locking members 238, 248. As shown in cross-section inFIG. 2, the window locking members 238, 248 force the tube 500 into theretention windows 255 when the first and second tabs 230, 240 are fullyinserted into the first and second cavities 216, 217. When deployed, thedevice rests against a patients skin 280, as shown in FIG. 2.

[0033] When tube closing members 237, 247 are included in first andsecond tabs 230, 240, they form a “valve” by substantially closing orpinching off the tube 500, as shown in FIG. 2. One of the effects ofthis valve is to prevent the discharge of material from within the bodythrough the tube 500. It is thus preferred that the tube closing members237, 247 are sized such that, when the first and second tabs 230, 240are fully inserted into first and second cavities 216, 217, the gapbetween the tube closing members 237, 247 is approximately equal to orless than twice the wall thickness of the tube. The formation of thisinternal valve represents a significant enhancement over conventionalretention systems, in which external valves add to the complexity ofsuch systems.

[0034] When the device 200 is used as part of a feeding system, anexternal feeding tube 510 is engaged with the device 200 as shown inFIG. 3. The external feeding tube 510 includes a portion that extendsthrough the valve formed by the tube closing members 237, 247 bycompressing the sides of the tube 500 against the tube closing members237, 247, as shown in FIG. 3. The extension member is preferably madefrom a rigid material, such as stainless steel.

[0035] The medical device 200 preferably includes a boot 270 that fitsover the base 210 and first and second tabs 230, 240 when inserted intothe base 210. If used, the boot 270 rests against the patient's skin,and is thus preferably made from a soft, elastomeric material such assilicone, polyurethane or latex. If a boot is not used with the presentinvention, it is preferred that a pad made from a soft, elastic materialsuch as silicone, polyurethane or latex, be placed between the patient'sskin and the base 210. Such a pad optionally includes an adhesivematerial on one or both sides.

[0036] When the boot 270 is used with the present invention, the medicaldevice is delivered to the physician or patient as shown in FIG. 4. Assuch, the medical device 200 is simply positioned over the tubepreferably having a stem 250 therein, the tube is positioned onto theupper surface 211 of the base 210, and the first and second tabs 230,240 are fully inserted into the first and second cavities 216, 217,respectively, to lock the tube into the medical device 200. The bootincludes upper and lower openings 271, 272 so that the tube can beinserted into the opening 215 in the base 210, and an external feedingtube can be inserted into the stem 250 for feeding the patient. The bootoptionally includes a plug 273 attached to the boot 270 by an arm member274 as shown in FIG. 5. The plug 273 is insertable into the end of thetube to prevent the flow of bodily fluids therefrom. In one embodiment,the plug 273 acts like a cap that closes the stem lumen when not in use.In another embodiment, the plug 273 includes a slit 275 that acts like avalve that can be opened by the insertion of a feeding tube.

[0037] The bottom surface of the boot (i.e., the surface that comes intocontact with the patient's skin) is preferably patterned with recesses,grooves, or the like (FIG. 6) to minimize the contact area between theboot and the patient. The boot also optionally includes flap(s) orear(s) 276 extending outward from the bottom surface, as shown in FIG.6. Such flaps 276 are attached to the boot 270 or are formed as anintegral part thereof, and are positioned on the bottom surface of theboot 270 at any suitable location, such as the corners as shown in FIG.6. Preferably, the boot 270 is formed with a flap 276 at each corner ofits bottom surface. The flaps 276 are used to secure (e.g., by suture)the boot 270 to the patient's skin, thereby holding the medical device200 in place during use.

[0038] The present invention includes several embodiments that arevariations of the embodiment shown in FIG. 1. For example, the device300 shown in FIG. 7 (top view) includes a base member 310 having baselocking members 318, 319 that are positioned on the sides of the basemember 310. Although the base locking members 318, 319 are shown in FIG.7 to extend through the base member 310, the base locking members 318,319 may simply comprise notches on the inner surface of the base member310.

[0039] Correspondingly, the first and second tabs 330, 340 each have atleast one locking tab feature 335, 345 that is (are) engagable withrespective locking base features 318, 319, as shown in FIG. 7. Forexample, the locking tab features 335, 345 snap into the respectivelocking base features 318, 319 when the tabs 330, 340 are advanced to aworking configuration. Although not shown in FIG. 7, the tabs 330, 340further comprise tube compression members and window locking members,and preferably include tube closing is members, as shown for tabs 230,240 in FIG. 1.

[0040] In another embodiment, the present invention includes a stem 350,a section of which is shown in FIG. 8, rather than the stem 250. Likethe stem 250, the stem 350 is designed to be inserted into the end of atube to be retained. The stem 350 includes a tubular bottom portion 351which comprises a cylindrical side wall, a top end 352 and a bottom end353; and a positioning member 354 at the top end 352 of said tubularbottom portion 351. The positioning member 354 includes an opening thatis coaxial with the tubular bottom portion 351. The outer diameter ofthe bottom portion 351 is preferably about the same or greater size thanthe inner diameter of a tube to be retained. The stem 350 furtherincludes a mechanical surface 355, such as a threaded or patternedsurface, to assist in gripping and holding a retained tube (as comparedto the window 255 of the stem 250). When stem 350 is used in the presentinvention, first and second tabs 230, 240 do not include window lockingmembers 238, 248.

[0041]FIG. 9 shows an embodiment of the present invention in which themedical device includes only one tab. In this embodiment, the medicaldevice 600 includes a base 610 and a first tab 630 that aresubstantially mirror images of each other. The base 610, shown in FIGS.10A (top view) and 10B (bottom view) includes an upper surface 611 and alower surface 612, which define an opening 615 for receiving a tube. Theupper and lower surfaces 611, 612 further define a first side cavity 616extending from the lower surface 612 of the base 610 and between theside walls 621. The base 610 includes a plurality of locking base teeth618 in the lower surface 612.

[0042] The medical device 600 includes a first tab 630 that issubstantially identical to the base 610. The first tab 630 is movablewithin the first side cavity 616 in the base 610. The first tab 630includes a plurality of locking tab teeth that are substantiallyidentical to the plurality of locking base teeth 618 as shown in FIG.10B. The locking tab teeth are engagable with the locking base teethwhen the first tab 630 is moved within the first side cavity 616. Boththe base 610 and the first tab 630 preferably include at least onelongitudinally extending ridge (shown as 619 for the base) that isengagable with respective corresponding grooves 620, 640 in respectiveside walls 621, 641.

[0043] A tube to be retained by the medical device 600 is insertedthrough the opening 615 after the first tab 630 has been partiallyinserted into the first side cavity 616 of the base 610. To completeretention, the first tab 630 is fully inserted into the first sidecavity 616 of the base 610, to thereby exert a compressive force on atube within the opening 615. The first tab 630 is held in position bythe engagement of the locking tab teeth with the locking base teeth. Inone embodiment, the tube to be retained has a stem inserted therein tohelp facilitate tube retention, as previously described for stems 250and 350. In another embodiment, the tube to be retained is held andpinched by the relative movement of the base 610 and the tab 630. Inthis embodiment, the tube to be retained preferably has a diameterlarger than that of the opening 615 such that when the first tab 630 isfully inserted into the base 610, it is pinched at intersections 625 oneither side of the opening 615. As such, when the first tab 630 is fullyinserted into the base 610, a valve is formed to thereby substantiallyclose the tube within the opening 615.

[0044] Another embodiment 700 of the present invention which makes useof a single tab is shown in FIG. 11. This embodiment includes a base 710having an upper surface 711, a lower surface 712, a proximal end 713 anda distal end 714. The upper and lower surfaces 711, 712 define anopening 715 for receiving a tube. The upper and lower surfaces 711, 712further define a first side cavity 716 extending from the opening 715 tothe proximal end 713. The base 710 includes a plurality of first lockingbase features 718 in the upper surface 711 between the opening 715 andthe proximal end 713. The base 710 also includes many of the featureswhich would otherwise be present in a second tab, if used. For example,base 710 includes a tube compression member 746 and a window lockingmember 748 extending from its distal end 714. The base 710 optionallyincludes a tube closing members 747, also extending from its distal end714.

[0045] The medical device 700 includes a first tab, such as that shownas 230 in FIG. 1. Tube retention is accomplished in the same manner asdescribed for the medical device 200, with the exception that a secondtab is not used. A cross-section of the device 700 is shown in FIG. 12,wherein the first tab 230 is inserted into the first side cavity 716 andthe device 700 is used to retain a tube 500.

[0046] Another embodiment of the present invention in which a stem isattached to the base is shown in FIG. 13. In this embodiment 800, thebase 810 includes an upper surface 811, a lower surface 812, and a stem850 extending from the upper surface 811 towards an opening 815 in thelower surface 812. The stem 850 is characterized by a cylindricalprofile that includes, for the embodiment shown in FIG. 13, a firstcylindrical portion 851 adjacent the upper surface 811, a secondcylindrical portion 852 adjacent the first cylindrical portion, and athird cylindrical portion 853 adjacent the second cylindrical portion.The second cylindrical portion 852 preferably has a diameter greaterthan either of the first or third cylindrical portions 851, 853. Thestem 850 is preferably formed as an integral part of the base 810, suchas by molding. The stem 850 preferably extends from the upper surface811 through the opening 815 in the lower surface 812. The stem 850 alsopreferably includes a valve housing 0.854 extending through the uppersurface 811.

[0047] Embodiment 800 includes a first side cavity 816, a second sidecavity 817, first locking base members 818, and second locking basemember 819, as shown in FIG. 14. Also included are first and second tabsthat are substantially identical in structure, such as the tab 830 shownin FIG. 15, that are moveable within the first and second side cavities816, 817. The tab 830 includes at least one locking tab feature 835 thatis (are) engagable with respective locking base features 818 or 819. Thetab 830 further includes a tube compression member 846 that conforms toat least part of the cylindrical profile of the stem 850.

[0048] When the device 800 is in use, a tube to be retained is placedthrough the opening 815 and over the stem 850. The tube preferably isplaced over the stem 850 until it abuts either the upper surface 811 ofthe body 810 or, if used, the valve housing 854. After the tube is sopositioned, the first and second tabs are moved within the first andsecond cavities 816, 817 such that the locking tab features, such as835, engage with the locking base features, such as 818. When fullyinserted, the first and second tabs hold the tube by compression withthe tube compression members, such as 846, which conform in shape to atleast part of the cylindrical profile of the stem 850.

[0049] The dimensions of the devices of the present invention arelimited only by manufacturing capabilities. The devices and theirrespective components are made by suitable methods known to those ofskill in the art, such as injection molding, casting, machining, and thelike. The devices are sized to fit, for example, feeding tubes of size#5 to #24 French, but can be sized for any other tube sizes byappropriate sizes of the base, tab(s) and stem.

[0050] The present invention provides for the low profile retention offlexible tubes that extend from the body as a result of any one of anumber of medical procedures. The medical devices of the presentinvention are easy to use, provide a high retention strength, andprovide a reliable valve and feeding system interface. Although thepresent invention has been described with respect to several exemplaryembodiments, there are many other variations of the above-describedembodiments which will be apparent to those skilled in the art, evenwhere elements have not explicitly been designated as exemplary. It isunderstood that these modifications are within the teaching of thepresent invention, which is to be limited only by the claims appendedhereto.

What is claimed is:
 1. A medical device for retaining an end of a tube,comprising: a base, comprising an upper surface and a lower surface;wherein at least one of said upper and lower surfaces define an openingextending from said upper surface to said lower surface, said openingfor receiving said tube; and said upper and lower surfaces define afirst side cavity between said upper and lower surfaces; and a first tabhaving a portion that is movable within said first side cavity, saidfirst tab comprising an upper surface, a lower surface, a proximal endand a distal end; and a first tube compression member extending from thedistal end of said first tab.
 2. The medical device of claim 1, whereinsaid base comprises a first locking base feature; said first tabcomprises a first locking tab feature; and said first locking tabfeature is engagable with said first locking base feature when saidfirst tab is within said first side cavity.
 3. The medical device ofclaim 2, wherein said first locking base feature comprises a firstplurality of teeth on said base; and said plurality of teeth on saidbase are engagable with said first locking tab feature.
 4. The medicaldevice of claim 2, wherein said first locking tab feature comprises aplurality of teeth on said first tab; and said plurality of teeth onsaid first tab are engagable with said first locking base feature. 5.The medical device of claim 2, wherein said first locking base featurecomprises a locking opening in said base; said first locking tab featurecomprises a locking member extending from said first tab; and saidlocking member is engagable with said locking opening.
 6. The medicaldevice of claim 2, wherein when said first locking tab feature isengaged with said first locking base feature, said first tubecompression member comes into contact with said tube.
 7. The medicaldevice of claim 1, wherein said first tab includes a first tube closingmember extending from the distal end of said first tab, and when saidfirst locking tab feature is engaged with said first locking basefeature, said first tube closing member extends into said opening insaid base.
 8. The medical device of claim 7, wherein when said medicaldevice is in use, said tube is placed through said opening in said basethrough said lower surface of said base, said first locking tab featureis engaged with said first locking base feature, and said first tubeclosing member pushes against a side of said tube to therebysubstantially close said tube.
 9. The medical device of claim 1, whereinsaid upper and lower surfaces of said base define a second side cavitybetween said upper and lower surfaces.
 10. The medical device of claim9, further comprising a second tab having a portion that is movablewithin said second side cavity, said second tab comprising an uppersurface, a lower surface, a proximal end and a distal end; and a secondtube compression member extending from the distal end of said secondtab.
 11. The medical device of claim 10, wherein said base comprises asecond locking base feature; said second tab comprises a second lockingtab feature; and said second locking tab feature is engagable with saidsecond locking base feature when said second tab is within said secondside cavity.
 12. The medical device of claim 11, wherein said secondlocking base feature comprises a second plurality of teeth on said base;and said second plurality of teeth on said base are engagable with saidsecond locking tab feature.
 13. The medical device of claim 11, whereinsaid second locking tab feature comprises a plurality of teeth on saidsecond tab; and said plurality of teeth on said second tab are engagablewith said second locking base feature.
 14. The medical device of claim11, wherein said second locking base feature comprises a locking openingin said base; said second locking tab feature comprises a locking memberextending from said second tab; and said locking member is engagablewith said locking opening.
 15. The medical device of claim 11, whereinwhen said second locking tab feature is engaged with said second lockingbase feature, said second tube compression member comes into contactwith said tube.
 16. The medical device of claim 11, wherein said secondtab includes a second tube closing member extending from the distal endof said second tab, and when said second locking tab feature is engagedwith said second locking base feature, said second tube closing memberextends into said opening in said base.
 17. The medical device of claim16, wherein when said medical device is in use, said tube is placedthrough said opening in said base through said lower surface of saidbase, said first locking tab feature is engaged with said first lockingbase feature, said second locking tab feature is engaged with saidsecond locking base feature, and said first tube closing member and saidsecond tube closing member push against said tube to therebysubstantially close said tube.
 18. The medical device of claim 1,further comprising a boot placed around said base, said boot comprisingan upper surface juxtaposed against said upper surface of said base; alower surface juxtaposed against said lower surface of said base; and afirst opening in said upper surface of said boot and a second opening insaid lower surface of said boot, said first and second openings of saidboot being in axial alignment with said opening in said base.
 19. Themedical device of claim 18, wherein said boot comprises an elastomericmaterial.
 20. The medical device of claim 18, further comprising a valvein said first opening of said boot.
 21. The medical device of claim 20,wherein said valve comprises an elastic material having athrough-thickness slit therein.
 22. The medical device of claim 18,further comprising a plug attached to said boot by an arm member, saidplug being insertable into the end of said tube to prevent the flow ofbodily fluids therefrom.
 23. The medical device of claim 18, whereinsaid boot includes a flap extending from the bottom surface thereof,said flap for attaching said boot to a patient.
 24. The medical deviceof claim 1, further comprising a stem comprising a tubular bottomportion insertable into the end of said tube, said tubular bottomportion comprising a cylindrical side wall, a top end and a bottom end;and a positioning member at the top end of said tubular bottom portion,said positioning member defining an opening coaxial with said tubularbottom portion; wherein when said medical device is in use, said tube isplaced through said opening in said base through said lower surface ofsaid base, said tubular bottom portion of said stem is placed into theend of said tube, and said positioning member rests against said uppersurface of said base.
 25. The medical device of claim 24, wherein thecylindrical side wall of said tubular bottom portion defines a retentionwindow; and when said first locking tab feature is engaged with saidfirst locking base feature, said tube compression forces at least partof said tube into said retention window.
 26. The medical device of claim24, wherein said cylindrical side wall has a mechanical surface thereon.27. The medical device of claim 24, wherein said base includes analignment recess in said upper surface of said base; and when saidmedical device is in use, said positioning member rests within saidalignment recess.
 28. The medical device of claim 24, further comprisinga feeding tube interface over said stem.
 29. The medical device of claim1, further comprising a stem attached to said upper surface of said basewhen said lower surface of said base defines said opening, said stemextending from said upper surface towards said opening, said stemcharacterized by a cylindrical profile, wherein when said medical deviceis in use, said tube is placed through said opening and over said stem;and said first tube compression member conforms to at least part of theprofile of said stem.
 30. The medical device of claim 29, wherein saidstem extends from said upper surface through said opening in said lowersurface.
 31. The medical device of claim 29, wherein said stemcomprises: a first cylindrical portion adjacent said upper surface; asecond cylindrical portion adjacent said first cylindrical portion; anda third cylindrical portion adjacent said second cylindrical portion;wherein said second cylindrical portion has a diameter greater thaneither of said first or third cylindrical portions.
 32. The medicaldevice of claim 31, wherein when said medical device is in use, saidtube is placed over each of said first, second and third cylindricalportions.
 33. The medical device of claim 29, wherein said stem furthercomprises a valve housing.